Senators want halt in release of PhilHealth’s IRM funds sans reforms

Photo from Radyo Inquirer

MANILA, Philippines — The release of the billions worth of funds through the Philippine Health Insurance Corporation’s (PhilHealth) Interim Reimbursement Mechanism (IRM) should be suspended until needed reforms are put in place, several senators said Wednesday.

Speaking with reporters in an online interview, Senate Majority Leader Juan Miguel Zubiri said the implementation of the IRM is tainted with “a lot of questionable transactions.”

During Tuesday’s Senate investigation, Senator Panfilo Lacson said a review of PhilHealth records showed a “pattern” that some hospitals, particularly private-owned, were favored in the distribution of IRM over state-owned hospitals.

It was also revealed that even weeks before the PhilHealth board approved the guidelines for the use of the IRM funds, the state insurer has already handed out cash advances to various hospitals, especially alleged “favored” health facilities.

“Yung binanggit ni Senator Lacson, yung B. Braun Avitum Philippines, P45 million ni-release sa kanila in less than 10 days. Napakarami namang public hospitals, hindi pa nabibigyan ni kusing na pondo ng Philhealth sobrang tagal nilang nagke-claim,” Zubiri went on.

(The one mentioned by Senator Panfilo Lacson, the B. Braun Avitum Philippines, P45 million had been released to them in less than 10 days. A lot of public hospitals, for the longest time asking for claims, had not been given a single centavo coming from PhilHealth fund.)

“We should suspend the release of the IRM until we can come up with a proper formula and accountability measures para sa pondong ito,” he added.

A PhilHealth official said during Tuesday’s resumption of the Senate into the PhilHealth mess that the state insurer has so far released P14.971 billion of the P30-billion IRM fund to over 700 health care institutions (HCIs).

IRM is an emergency cash advance measure of PhilHealth to provide hospitals with an emergency fund to respond to natural disasters, calamities as well as other unexpected events.

Lacson, in a message to reporters, said PhilHealth should temporarily suspend the release of more funds through the IRM to purge its system of “unauthorized recipients.”

“…Suspend the disbursements for a very limited period just to review the list of HCI’s for purging of unauthorized recipients,” he said.

Resolve ‘favoritism’ issue

Senator Risa Hontiveros shared her colleagues’ sentiment in calling for a suspension of the release of IRM funds.

“PhilHealth should suspend the IRM up until we can resolve the issues of favoritism, inequitable distribution and liquidation,” she said in a separate message.

“Ang daming tanong na kailangan pang sagutin ng PhilHealth sa prosesong ito. Until we are confident that a system can be put in place to ensure that PhilHealth funds are not being corrupted, the IRM has to be suspended,” she added.

(So many questions that need to be answered by PhilHealth in this process.)

For Senate President Vicente Sotto III, a better option for PhilHealth is to “replace its entire leadership with reliable and incumbent employees.”

Nevertheless, he still said the implementation of the IRM should be suspended.

Senator Francis Pangilinan, meanwhile, proposed a revision and redistribution of the approved allocations under the IRM.

“The current allocation system is a complete disaster and is a huge stumbling block for our hospitals to be able to effectively address the killer pandemic,” he said.

For his part, however, Senator Sonny Angara said the release of funds through the IRM should not be suspended yet but instead be examined if it had been “responsive to the needs of the times.”

“[A]side from other common ailments of our kababayans dapat i-prioritize yung funding for testing especially since many of the lower income sectors have expressed frustration at being unable to get tested for COVID-19,” he said.

Senator Joel Villanueva, on the other hand, noted that the IRM was designed to provide cash advances for medical facilities handling COVID-19 patients.

“All releases of IRM should only cater to this requirement, [especially] at this point in time. Other facilities handling non-COVID cases should continue to follow its regular processing of claims,” Villanueva said.

According to the senator, the state insurer has “all the power and authority” to make it easier for hospitals and other medical facilities to expedite their regular process for claims.

“Private hospitals are already overburdened with the nonpayment of their claims, and if they are forced to close, our healthcare system might collapse,” he added.

JPV